26PMEHSACUTEHOSPITAL: Rate Year 2026 Acute Hospital Request for Applications

The Massachusetts Executive Office of Health and Human Services (EOHHS) has issued a Request for Applications (RFA) for Rate Year 2026 to solicit participation from eligible in-state acute hospitals seeking to be MassHealth providers. This RFA outlines comprehensive requirements and guidelines governing the provision of acute hospital services under MassHealth, including eligibility criteria, covered services, reimbursement methodologies, supplemental payment structures, billing and reporting obligations, and program compliance mandates. The contract period spans October 1, 2025, through September 30, 2026, with applications due by September 30, 2025. Inquiries must be submitted by September 12, 2025, to the designated contact, Jin Pantano. The solicitation emphasizes adherence to quality benchmarks, hospital operational standards, and regulatory criteria ensuring the delivery of acute inpatient and outpatient services consistent with Medicaid program requirements in Massachusetts. Financial provisions detail payment systems that encompass adjudicated base rates, outlier payments, and additional funds for behavioral health and hospitals serving high Medicaid volumes or specialized populations. Applicants must comply with mandatory reporting metrics such as greenhouse gas emissions, accident notifications, discharge planning, and quality improvement initiatives under the Clinical Quality Incentive (CQI) program. Evaluation of applications is governed by performance-based criteria across domains including care coordination, patient safety, and management of acute and chronic conditions, with scoring reflecting attainment and improvement on specified measures. While no formal federal FAR clauses apply, the contract incorporates state regulatory standards, data security requirements, and operational conditions such as appointment of a Hospital Key Quality Representative. Submission protocols allow electronic or physical delivery of application materials, requiring validated signatures and adherence to administrative instructions. Inspection and acceptance criteria hinge on compliance with contractual obligations and documented quality metrics, with EOHHS retaining audit and enforcement authority. The comprehensive framework establishes a structured pathway for acute hospitals to engage as MassHealth providers under the 2026 rate year.